0:08Skip to 0 minutes and 8 secondsSo, I'm delighted to be chatting to Dr Jennifer Wild, who's a clinical psychologist, about PTSD. Could you begin just defining what PTSD is? PTSD is a stress disorder. And the main symptom which characterises PTSD are unwanted, intrusive memories of the trauma that come flashing back into somebody's mind when they least expect it. The memories are terrifying. They take their attention away from what they're doing. They might cause them to avoid walking down the street in case they come across a trigger. And they will cause them to have very hyper-aroused state in their body. So, they'll have problems sleeping. They'll be very hyper-alert, checking for danger, difficulty concentrating.

1:00Skip to 1 minute and 0 secondsAnd if you can imagine, you're going about your daily life and suddenly your flooded with these terrifying memories, how difficult it is and how scary it is to actually not be able to control what's in your mind. It's absolutely frightening. And PTSD can have such an impact on someone's entire life. It can affect their relationships, because they may become more irritable with the lack of sleep. They won't necessarily be functioning very well if they're working, because they have very terrifying memories coming into their head, taking their attention away from what they're doing. It can really turn somebody's life upside down.

1:34Skip to 1 minute and 34 secondsSo, often what starts after trauma might be post-traumatic stress disorder, but then people develop other problems, such as depression, as their relationships are affected and potentially they could lose their job. And are all these stress hormones just sort of released in the body and raging around the body? Is that what's happening to cortisol and all sorts of things are coursing through the nervous system? What we think happens is when someone is confronted with a trigger, then their stress hormones are released. It's almost like they're re-traumatised every time they see a trigger.

2:07Skip to 2 minutes and 7 secondsSo for example, if somebody's had a car accident, then seeing a car might be a trigger for that horrific memory of their car accident to come back into their mind. So when they see a car, then the stress hormones will be released again. And it might feel like their accident is happening all over again. So, you can see how this would be such an intrusive disorder in somebody's life. Because it's not just that they've had a trauma in the past. But it often feels like it's ongoing today. They're reliving it. It's frightening and it's debilitating, presumably. Exhausting. It's exhausting. It's debilitating. People can't sleep with it.

2:38Skip to 2 minutes and 38 secondsBecause it's almost like there's lots of adrenaline coursing through their body, because they constantly feel on edge and threatened. So, they have sleep problems. It's difficult to fall asleep, difficult to concentrate. You can imagine, when you're not sleeping, you also have memory problems, which doesn't help with their ability to consolidate the trauma memory. Just in terms of the time-frame, how does it affect different people? Say, for instance, as a clinical psychologist, do you see lots of variation in how people present their symptoms in terms of the time-scale? Absolutely there's variation in terms of how people present. Typically, in my clinical practice, most people come to see me for treatment after about 10 years of suffering.

3:24Skip to 3 minutes and 24 secondsAnd I think part of the problem with getting help for PTSD is that it's not well recognised. So, if somebody's having symptoms, they're going to be having flashbacks and memories and sleep problems. They're going to be avoiding various triggers that bring back the memories. But when they see their doctor, they might just talk about feeling low or having sleep problems. So, obviously they're going to get treated for potentially depression or sleep problems, without actually their PTSD being recognised and then treated. So, we see a very delayed onset for treatment with PTSD. And the average timespan is about 10 years from actually having a trauma to actually getting the help. That is fascinating.

4:04Skip to 4 minutes and 4 secondsOne of the things that I'm quite keen to emphasise on this course is I'm trying to slightly explore PTSD and open up the notion of it. Because I think for some people they think about Wilfred Owen and Craiglockhart and shell shock, as it was then called. But I've been very keen to look at different literary works that explore PTSD from a female angle, for instance. So, miscarriage, you talked about people being assaulted. Is it fair to say that it would be helpful to sort of explore the notion of what PTSD means today? Absolutely. PTSD can result from any particular trauma that is significant for an individual person. So, one person may have a miscarriage and not develop PTSD.

4:52Skip to 4 minutes and 52 secondsAnd another person will have a miscarriage and develop PTSD. And it really comes down to what the person thought was happening at the time and the meaning of the event for that particular individual. Somebody could develop PTSD from being assaulted by a toy gun, for example. But if they really thought they were being assaulted with a real gun and thought, at the time, they were going to die, they are more than likely going to develop PTSD. Gosh. Can I read a poem to you?

5:21Skip to 5 minutes and 21 secondsOne of the poems that we're looking at is a poem that was written a very long time ago, in the 1600s, by a woman called Katherine Philips, who was a poet, and had lost many, many children in miscarriage. And I think it's incredibly powerful and resonates certainly with me and I think for a lot of people. It's so contemporary. One of the things we're trying to do with the course is to say poetry can help you find words that you can't find yourself. And it helps us with the feeling of, I'm not so alone. Somebody else felt like that. And that can confer a degree of helpfulness and empathy. So, would you mind if I read the poem?

6:01Skip to 6 minutes and 1 secondI'd love it. Yes, please. So, the poem by Katherine Philips is called, 'On the Death of my First and Dearest Child, Hector Philips, born the 23rd of April, and died the 2nd of May 1655'. 'Twice 40 months in wedlock I did stay, then had my vows crowned with a lovely boy. And yet in 40 days he dropped away. Oh, swift vicissitude of human joy. I did but see him and he disappeared. I did but touch the rosebud and it fell. A sorrow unforeseen and scarcely feared, so ill can mortals their afflictions spell. And now (sweet babe) what can my trembling heart suggest to right my doleful fate or thee? Tears are my muse and sorrow all my art.

6:53Skip to 6 minutes and 53 secondsSo piercing groans must be thy elegy. Thus whilst no eye is witness of my moan, I grieve thy loss (ah, boy too dear to live!) And let the unconcerned world alone, who neither will nor can refreshment give. An offering too for thy sad tomb I have, too just a tribute to thy early hearse. Receive these gasping numbers to thy grave, the last of thy unhappy mother's verse'. I just think it's extraordinary. Somebody who's experienced a miscarriage, I think if she somehow is able to convey the feelings you have as a mother, which is so hard to explain to somebody else, because they're your feelings.

7:42Skip to 7 minutes and 42 secondsAnd I think, for me, the power of poetry and literature is being able to express or read about someone else who can express in words better then you can find. I can't find these words. I feel them. But I can't necessarily find them. But she's found them. And so it helps me articulate, I suppose, some of those emotions. So, what people with PTSD often say is that they feel alienated from other people, because they can't describe their experience. Or they feel alienated because somebody else hasn't been through it and can't possibly understand what they've been through. And this is exactly what's conveyed in this poem. She's absolutely able to convey her experience in a way that everybody gets.

8:26Skip to 8 minutes and 26 secondsAnd so she creates a sense of connection. And people with PTSD often experience social isolation. And in fact, one of the symptoms is a numbness and feeling detached from others. And yet, this creates a sense of connection. And I get what she's feeling very, very directly. And I absolutely can't believe it was written in 1653. It's a very long time ago. But it is. It feels very, very current and relevant to women who will be having miscarriages today and experiencing loss. I think when she says, 'Whilst no eye is witness off my moan, I grieved, thy loss' I love her saying in the writing of this poem, it's almost as though she feels alienated and nobody really understands it.

9:08Skip to 9 minutes and 8 secondsBut by writing the poem, giving form to the sorrow, it's articulating that. And I wonder whether that's helpful. Because talking about things, expressing, articulating, do you think that could be helpful for PTSD sufferers? Absolutely. It's really important to talk about the trauma. And it's part of the trauma-focused therapies that help people to fully recover from PTSD. Part of that therapy will be helping people to talk through the trauma, what actually happened. And to update their memories of what happened, so that some of their worst meanings are no longer carried forward. So, if one of their worst meanings was that they were all alone at the time, that that gets updated and they have an experience that they're not alone today.

9:52Skip to 9 minutes and 52 secondsThat's very important. And so in England, trauma-focused therapy is recommended by the National Institute for Clinical Health and Excellence. In the United States, exposure therapy, also exposing somebody to the trauma memory, as well as expressive writing, narrative therapy is very common. So, writing about the actual trauma. In a sense, writing your story. Writing about the trauma story is a very important part of therapy. And now, as therapies move much more towards internet-based treatments, writing about a trauma story is part of internet-based therapy for PTSD. So, suffers with PTSD, if they're having internet-based treatment, more than likely will have to write about their trauma story.

10:36Skip to 10 minutes and 36 secondsIt will be a written account that will be shared with their therapist and various parts, the worst meanings of the story, will be looked at and hopefully updated to reduce the very painful emotions associated with them. It's interesting you talk about the internet, because I'm very struck by various forums where people are able to share stories about stress and trauma. And the comments in which people say it's incredibly helpful to hear that you went through this and that this helped for you and whilst that might not have worked for me. And I think the internet is an incredible resource for the sharing of those stories in the battle to not feel alone. Absolutely.

11:17Skip to 11 minutes and 17 secondsAnd we know in terms of what prevents the development of PTSD is having social support. And in the same vein, what can help people to recover from PTSD is social support. And the internet can provide social support. Dr Jennifer Wild, thank you so much. We've done some more thinking and talking about PTSD and women in poetry with Dr Sophie Ratcliffe, who's a university lecturer in English literature.

Physiology of trauma: Discussion with Dr Jennifer Wild

Dr Jennifer Wild is a consultant clinical psychologist who specialises in PTSD.

Jen spoke to us about the modern understanding of PTSD, outlining the main symptoms of the condition, as well as explaining its causes and triggers. During our conversation, Jen emphasises how debilitating and isolating PTSD can be for sufferers. The condition is still not widely acknowledged or understood; in her clinical practice, Jen typically finds that patients don’t seek help for PTSD until around 10 years after the original traumatising event, with their symptoms regularly being misdiagnosed as depression or insomnia.

In our conversation, we also discuss modern treatments for PTSD, exploring the links between writing and recovery. Reading texts written by others who have experienced trauma can help sufferers to feel less isolated, while writing about a personal trauma can be a way of consolidating and updating a traumatic memory, and beginning to move on from it.

During our conversation, we discuss the following Katherine Philips poem:

On the Death of my First and Dearest Child, Hector Philips,
born the 23rd of April, and died the 2nd of May 1655

Twice forty months in wedlock I did stay,
Then had my vows crowned with a lovely boy.
And yet in forty days he dropped away;
O swift vicissitude of human joy!

I did but see him, and he disappeared,
I did but touch the rosebud, and it fell;
A sorrow unforeseen and scarcely feared,
So ill can mortals their afflictions spell.

And now (sweet babe) what can my trembling heart
Suggest to right my doleful fate or thee?
Tears are my muse, and sorrow all my art,
So piercing groans must be thy elegy.

Thus whilst no eye is witness of my moan,
I grieve thy loss (ah, boy too dear to live!)
And let the unconcerned world alone,
Who neither will, nor can refreshment give.

An offering too for thy sad tomb I have,
Too just a tribute to thy early hearse;
Receive these gasping numbers to thy grave,
The last of thy unhappy mother’s verse.